Who Truly Pays the Price for Contraception?

INTRODUCTION:

by: Sachi Moran

The conversation about expanded access to reproductive health services has generated great controversy. A major argument in favor of this access focuses on the economic benefits, both long and short term, that these services provide. Women’s health providers present the argument that access to healthcare and family planning improves the economic status of women as individuals and for society as a whole because it increases women’s access to education and work. Research and studies support the well-developed argument for the economic benefits of widely available reproductive health care for women.

There are many moral and social arguments in favor of women’s access to healthcare and family planning, but the claim that these services are economically beneficial is based on facts and statistics.Researchers have examined policy changes regarding access to contraception over time and analyzed the economic effects they have. While opponents of expanded access rely heavily on religious, philosophical, and moral arguments, the economic benefits of family planning services for women are clearly supported by the data.

 

WHO/WHY:

Many arguments in favor of women’s access to reproductive healthcare come from organizations which provide these services, which also include birth control that is used for medical reasons other than family planning. This particular argument is no different. Non-profit women’s healthcare and advocacy organizations such as Planned Parenthood Federation of America (PPFA) and the Guttmacher Institute believe that all women should have access to family planning as a critical part of their healthcare. Because of how they receive funding, not surprisingly, organizations such as these have a great incentive to justify their existence and prove that their services are cost effective. Recently, the state of Texas declared that Planned Parenthood would no longer be receiving state medicaid funds because of allegations claiming that fetal tissues were being sold at their clinics (Lachman). While these allegations were proven false on many occasions, the clinics were still shut down. While this is a somewhat unique case, there are still countless pro-life arguments that aim to completely defund Planned Parenthood.

While trying to appear fund-worthy may seem self promoting, it is actually helping them meet critical needs. Presenting a case for why they are important is simple for Planned Parenthood to do, as they rely primarily on factual evidence. They explain that since 2014, 99% of sexually active women have used some form of birth control in their lives. This includes the two thirds of Catholic women using birth control since 1970. In addition, nearly 60% of women using oral contraceptives (“the pill”) use for reasons not related to sexual activity such as acne and unmanageable periods.

Since the legalization of the pill in 1960, birth control has become a widely practiced form of medicine and family planning among women. However, despite its popularity and demand, contraception has not always been and continues to be difficult to access. For example, data analysed by the National Center for Biotechnology Information (NCBI)’s Health Services Research department found that in California until just over fifteen years ago, the majority of women between 100 and 200 percent of the federal poverty line were ineligible for Medicaid and the access to contraception that it covers. Organizations like Planned Parenthood fill this gap and provide for women who are above the poverty line yet still cannot afford the care they need. In order for all women to have access to the care that they need, (their providers/PPFA/other word choice) need to stay well funded.

Advocates for women’s health and family planning direct their appeals primarily towards policy-makers. While most left-leaning Democratic and liberal voters are already pro-choice, most right-leaning Republican and conservative voters are pro-life. Pro-life people in the general population who have moral or ethical reasons to be anti-abortion are too hard to persuade to make it worthwhile, so PPFA focuses more attention towards persuading others with greater political pull. Planned Parenthood highlights a history and timeline of policy changes regarding access to contraception.  Under presidents such as Nixon, Clinton, and Obama, access to family planning was increased, while under pro-life Presidents such as Reagan, G. H.W. Bush, and G. W. Bush, policies shifted and access to health services were restricted.. As the 2016 presidential election approaches, the fragile fate of women’s access to health and family planning lies in the hands of Obama’s successor. Because policy changes carry the most weight in determining the accessibility of reproductive health, women’s health providers and advocates aim their research and fact-based arguments towards those in charge of policy changes.  Arguing simply that women are people and have the right to make their own choices has not proven to be a strong enough claim to earn women the access to the services they need.

 

CASE STUDY:

With access to family planning comes greater freedom and choice in a woman’s life. According to the Guttmacher Institute, “Historical research has linked state laws granting unmarried women early legal access to the pill (at age 17 or 18, rather than 21), to their attainment of postsecondary education and employment, increased earning power and a narrowing of the gender gap in pay, and later, more enduring marriages.” Additionally, studies found that between 1960 (the year the pill was legalized) and 1970, for women in their early 20s, enrollment in higher education for women who had easy access to contraception was 20% higher than for women without access. More modern research has found that similar to how in the sixties and seventies the pursuit of education increased, today women entering the workforce and obtaining professional level jobs has increased. As greater numbers of women can avoid unwanted pregnancies, especially in their teen years, they are able to attain higher levels of education and work, moving towards closing the gender wealth gap.

Access to contraception has and continues to improve not only women’s individual economic status, but also saves taxpayer dollars. Analysis of a data conducted by NCBI’s Health Services Research found that the unintended pregnancies averted by California’s Family Prevention Access Care and Treatment (PACT) program would have cost the public 1.1 billion dollars within two years, and 2.2 billion within five. Those costs would have been significantly greater than the 408.3 million dollars spent on the family planning program. They explain that, “Each dollar spent generated savings of $2.76 within 2 years and $5.33 within 5 years.” Public money spent helping women to plan when they have children saves the money that would otherwise be spent on the pre and postnatal care for low income women on Medicaid and Medi-cal. Additionally, “women at or below 200 percent of the FPL and their children can qualify for other public services during or following birth: medical services, income support, social services, services for children with special needs, and services for pregnant or parenting adolescents” (NCBI), all of which are paid for by the public sector. The prevention of unwanted pregnancies is beneficial to the mother, the child, and taxpayers.

 

CONCLUSION:

Today, Obama’s introduction of the Affordable Care Act has made it mandatory for health care plans to include contraception. However this mandate has been denied by certain providers for religious purposes. While Obama and other Democrats advocate for women’s access to their necessary care, they are constantly obstructed by pro-life Republicans. As seen in Texas, women’s care providers remain subject to

The discussion over who should pay for women’s healthcare continues to be highly controversial. While it may be an overly optimistic view, it seems that the future of access to family planning will only progress from here. However, as the 2016 presidential election approaches, the security of current reproductive rights and their future remains vulnerable. Like so many other polarizing issues in the current political situation, each party has diametrically opposed views and plans surrounding the topic, and as seen in the past, presidents and their policies have huge effect on women’s lives and rights. Whether or not this is a divide that can be eliminated or even narrowed remains to be seen.